title: Drug administration errors in hospital inpatients: a systematic review.
abstract: BACKGROUND
  Drug administration in the hospital setting is the last barrier before a possible error reaches the patient.
  
  
  OBJECTIVE
  We aimed to analyze the prevalence and nature of administration error rate detected by the observation method.
  
  
  METHODS
  Embase, MEDLINE, Cochrane Library from 1966 to December 2011 and reference lists of included studies.
  
  
  METHODS
  Observational studies, cross-sectional studies, before-and-after studies, and randomized controlled trials that measured the rate of administration errors in inpatients were included.
  
  
  METHODS
  Two reviewers (senior pharmacists) independently identified studies for inclusion. One reviewer extracted the data; the second reviewer checked the data. The main outcome was the error rate calculated as being the number of errors without wrong time errors divided by the Total Opportunity for Errors (TOE, sum of the total number of doses ordered plus the unordered doses given), and multiplied by 100. For studies that reported it, clinical impact was reclassified into four categories from fatal to minor or no impact. Due to a large heterogeneity, results were expressed as median values (interquartile range, IQR), according to their study design.
  
  
  RESULTS
  Among 2088 studies, a total of 52 reported TOE. Most of the studies were cross-sectional studies (N=46). The median error rate without wrong time errors for the cross-sectional studies using TOE was 10.5% [IQR: 7.3%-21.7%]. No fatal error was observed and most errors were classified as minor in the 18 studies in which clinical impact was analyzed. We did not find any evidence of publication bias.
  
  
  CONCLUSIONS
  Administration errors are frequent among inpatients. The median error rate without wrong time errors for the cross-sectional studies using TOE was about 10%. A standardization of administration error rate using the same denominator (TOE), numerator and types of errors is essential for further publications.
authors.affiliation: Department of Pharmacy, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Berdot
authors.forename: Florence
authors.initials: F
authors.lastname: Gillaizeau
authors.forename: Thibaut
authors.initials: T
authors.lastname: Caruba
authors.forename: Patrice
authors.initials: P
authors.lastname: Prognon
authors.forename: Pierre
authors.initials: P
authors.lastname: Durieux
authors.forename: Brigitte
authors.initials: B
authors.lastname: Sabatier
mesh_terms: D003430:Cross-Sectional Studies; D006761:Hospitals; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000706:statistics & numerical data*; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic